Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $877.85 / $2,769.52 / $18,711.00	Facility		$877.85	$2,769.52	$18,711.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $454.92 / $671.38 / $979.24	Facility	54	$454.92	$671.38	$979.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $457.19 / $662.22 / $1,305.65	Professional		$457.19	$662.22	$1,305.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,160.88 / $4,554.63 / $11,500.00	Facility		$1,160.88	$4,554.63	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,896.69 / $3,154.80 / $3,154.80	Facility	54	$1,896.69	$3,154.80	$3,154.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $676.91 / $1,080.48 / $4,189.50	Professional		$676.91	$1,080.48	$4,189.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $1,985.59	Facility		$466.83	$568.48	$1,985.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $463.15 / $855.93 / $1,458.49	Professional		$463.15	$855.93	$1,458.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $478.50 / $970.40 / $1,575.30	Facility		$478.50	$970.40	$1,575.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $445.25 / $949.82 / $1,528.97	Professional		$445.25	$949.82	$1,528.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $288.03 / $977.02	Professional		$73.20	$288.03	$977.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $645.82 / $883.73 / $964.13	Facility		$645.82	$883.73	$964.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $633.29 / $1,613.81	Facility		$537.44	$633.29	$1,613.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $729.60 / $1,046.15 / $1,305.32	Professional		$729.60	$1,046.15	$1,305.32
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,953.48 / $4,552.03 / $8,712.50	Facility		$2,953.48	$4,552.03	$8,712.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $645.88 / $936.04 / $1,246.17	Professional		$645.88	$936.04	$1,246.17
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $559.53 / $762.66 / $1,349.01	Professional		$559.53	$762.66	$1,349.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $400.58 / $400.58 / $525.91	Professional		$400.58	$400.58	$525.91